title: Distribution of cytomegalovirus gN variants and associated clinical sequelae in infants.
abstract: BACKGROUND
  Human cytomegalovirus (HCMV) is the most widespread cause of congenital infection. The effects of various viral strains and viral loads on the infection outcome have been under debate.
  
  
  OBJECTIVE
  To determine the distribution of gN variants in HCMV strains isolated from children with congenital or postnatal infection and to establish the relationship between the viral genotype, the viral load, and the sequelae.
  
  
  METHODS
  The study population included congenitally HCMV-infected newborns and children with postnatal or unproven congenital HCMV infection. The genotyping was performed by RFLP analysis of PCR-amplified fragments, and the viral load was measured by quantitative real-time PCR.
  
  
  RESULTS
  Our results demonstrated that the HCMV genotypes gN3b, gN4b, and gN4c were prevalent in the patients examined. There were no differences in the distributions of gN genotypes in the congenitally and postnatally infected children. Multiple HCMV strains were detected in both groups of children. A significant association between the HCMV gN4 genotype and the incidence of neurological disorders was observed (p=0.045). Our results suggest that the detection of the gN2 or the gN4 genotype may be indicative of serious manifestations in children. In contrast, the gN3b and the gN1 genotypes represent less pathogenic HCMV strains. The HCMV load in urine was significantly higher in children with congenital infection compared with children with postnatal infection. No correlation was found between the viral load and the genotype.
  
  
  CONCLUSIONS
  Our results suggest that the gN genotype may be a virological marker of symptomatic HCMV infection in newborns.
authors.affiliation: Laboratory of Molecular Virology and Biological Chemistry, Institute of Medical Biology, Polish Academy of Sciences, Lodz, Poland. eparadowska@cbm.pan.pl
authors.forename: Edyta
authors.initials: E
authors.lastname: Paradowska
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Jabłońska
authors.forename: Mirosława
authors.initials: M
authors.lastname: Studzińska
authors.forename: Patrycja
authors.initials: P
authors.lastname: Suski
authors.forename: Beata
authors.initials: B
authors.lastname: Kasztelewicz
authors.forename: Barbara
authors.initials: B
authors.lastname: Zawilińska
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Wiśniewska-Ligier
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Dzierżanowska-Fangrat
authors.forename: Teresa
authors.initials: T
authors.lastname: Woźniakowska-Gęsicka
authors.forename: Justyna
authors.initials: J
authors.lastname: Czech-Kowalska
authors.forename: Bożena
authors.initials: B
authors.lastname: Lipka
authors.forename: Maria
authors.initials: M
authors.lastname: Kornacka
authors.forename: Dorota
authors.initials: D
authors.lastname: Pawlik
authors.forename: Tomasz
authors.initials: T
authors.lastname: Tomasik
authors.forename: Magdalena
authors.initials: M
authors.lastname: Kosz-Vnenchak
authors.forename: Zbigniew J
authors.initials: ZJ
authors.lastname: Leśnikowski
mesh_terms: D000328:Adult; D003587:Cytomegalovirus / Q000145:classification* / Q000235:genetics*; D003586:Cytomegalovirus Infections / Q000151:congenital / Q000473:pathology* / Q000821:virology*; D004279:DNA, Viral / Q000235:genetics; D005819:Genetic Markers; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012150:Polymorphism, Restriction Fragment Length; D060888:Real-Time Polymerase Chain Reaction; D014759:Viral Envelope Proteins / Q000235:genetics*; D019562:Viral Load
chemical_list: D004279:DNA, Viral; D005819:Genetic Markers; D014759:Viral Envelope Proteins; C417883:glycoprotein N, Human cytomegalovirus
keywords: CI; CNS; CSF; Congenital infection; GE; Glycoprotein N; HCMV; Human cytomegalovirus; IUGR; OR; RFLP; SNHL; UPGMA; central nervous system; cerebrospinal fluid; confidence interval; gC; gN; genome equivalents; glycoprotein N; glycoprotein complex; human cytomegalovirus; intrauterine growth retardation; nPCR; nested polymerase chain reaction; odds ratio; restriction fragment length polymorphism; sensorineural hearing loss; unweighted pair group method